Figure 1.

Alcohol, diet, obesity, and genetic factors—all affect gut microbiota leading to dysbiosis with intestinal bacterial overgrowth, increased intestinal permeability with subsequent bacterial translocation and endotoxemia stimulating development of HCC. Figure was created and adapted from Gupta et al. 2019 (34). HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HBV, hepatitis B virus; HSC, hepatic stellate cell; ROS, reactive oxygen species; TLR, toll-like receptor; IR, insulin resistance; LPS, lipopolysaccharide; TNF, tumor necrosis factor; SCFA, short-chain fatty acid; DAMP, damage-associated molecular patterns; PAMPs, pathogen-associated molecular patterns; TMA, trimethylamine.